| Objective:Laterally Spreading tumor(LST)is a type of superficial lesion of large intestine with a diameter greater than 10 mm and the main characteristic of lateral growth.This lesion is a special form of precancerous lesions in colorectal cancer,which is closely related to colorectal cancer,and its growth form is special and the site is hidden.Therefore,early detection and treatment can effectively prevent canceration.The purpose of this study was to studied the morphological characteristics of LST and early-stage cancer under endoscopy,and compared the advantages of different endoscopic treatment methods for early-stage cancer and non-early-stage cancer,in order to improve the endoscopic detection rate of LST and to provide reference for the selection of treatment for patients with early-stage cancer.Methods:A retrospective study was conducted on patients with LST detected by electronic colonoscopy from January 2017 to December 2021 in The Affiliated Hospital of Inner Mongolia Medical University and confirmed by histopathology after endoscopic treatment.Compare and analyze the following data:(1)morphological characteristics,distribution characteristics and differences and characteristics of histopathology of LST classification.(2)Advantages and disadvantages of different treatment methods of ESD and EMR for treatment of LST,so as to select more appropriate treatment method for early-stage cancer.Results:1.The first part included 134 patients with 138 lesions.According to subtype classification,there was statistical difference in diameter(P=0.016),and the incidence of early-stage cancer in lesions with diameter ≥ 30 mm was significantly higher than that of non-early-stage cancer(55.74% and 23.38%,respectively;P=0.001).There was statistical difference in the malignancy probability of LST lesions of different subtypes(P=0.029).Both LST-NGPD and LST-GM have higher canceration rate(66.67% and 55.26%,respectively).The probability of LST-NGFE and LST-GH progressing to early-stage cancer was less than LST-NGPD and LST-GM,(25.00% and30.77%,respectively).In the distribution of lesions,there was a higher proportion of LST lesions in rectal,both early-stage and non-early-stage cancer.2.The second part included 100 patients with 104 lesions.A comparative analysis showed that ESD was more suitable for larger lesions and had a higher complete resection rate,and the positive rate of resection margin was significantly lower than EMR by statistical analysis statistically significant(P=0.012).There was no statistical difference between the two treatment methods for complications such as bleeding and infection(P > 0.05).The volume of early-stage cancer was significantly larger than that of non-early-stage cancer,and the difference was statistically significant(P=0.025).The resection rate of the two surgical methods was statistically different in the non-early-stage cancer group(P=0.044).The en-bloc and complete resection rate and complications of early-stage cancer and non-early-stage cancer treated by ESD were basically similar to the overall data,but patients with early-stage cancer needed longer hospitalization period than those with non-early-stage cancer(P=0.014).Conclusion:1.The proportion of LST-GM and LST-NGPD with volume≥30mm distributed in rectal lesions was high.LST-NGPD and LST distributed in rectum are more prone to submucosal invasion.2.Based on various indicators,ESD is recommended as the preferred treatment for LST.ESD surgery is beneficial to patients with lesions with diameter≥30mm and microscopic features suggesting a high risk of early-stage cancer. |
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